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NPI Code Detail

MEDICARE: HEATHER MARIE GARDNER RN

MEDICARE: HEATHER MARIE GARDNER RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN.409690OH

General Provider Information

NPI Number : 1255907879
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER MARIE GARDNER RN
Provider Business Mailing Address
First Line : 39051 STATE ROUTE 26
Second Line :
City : GRAYSVILLE
State : OH
Zip : 45734-9996
Country : US
Telephone Number : 740-525-5255
Fax Number :
Provider Business Practice Location Address
First Line : 67670 TRACO DR
Second Line :
City : SAINT CLAIRSVILLE
State : OH
Zip : 43950-9375
Country : US
Telephone Number : 740-695-2131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2021
Last Update Date : 06/03/2021

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Directions to “ HEATHER MARIE GARDNER RN” Practice Location

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